Clinical Efficacy and Safety of Remdesivir among Hospitalised Adult Patients with RT PCR Confirmed COVID 19 Requiring ICU Care in Kalyana Karnataka.

BACKGROUND: Despite global efforts, COVID 19 pandemic is still posing a serious challenge with dearth of effective treatment options. Remdesivir has got FDA approval as the first COVID-19 anti-viral agent in adult and paediatric patients (aged ≥12 years and weighing at least 40 kg) requiring hospitalization. OBJECTIVE: The present prospective, observational, cross sectional study was planned to evaluate the impact of early initiation of Remdesivir on clinical outcomes in moderate to severe COVID 19 patients requiring ICU care. Materials and Methods: In this study, 100 consecutive symptomatic RT-PCR positive COVID 19 patients requiring admission to Intensive care unit based on predefined criteria were included for evaluation. All such moderate to severely ill patients were given Remdesivir intravenously as a 200-mg loading dose on day 1, followed by a 100-mg maintenance dose for the next four days along with other standard care. The main outcome measure analysed was the impact of early initiation of Remdesivir on recovery assessed by number of days in hospital, recovery, biochemical improvements and death. Results: Out of total 100 patients, 84 patients recovered with Remdesivir along with supportive treatment and were discharged from the hospital. Mean age of patients at presentation 53.5± 14.8 years with 5:1 male preponderance. Mean duration of hospital stay was 11.6 ± 5.9 days. D-dimer, CRP, Ferritin, IL-6 decreased significantly post treatment with P values <0.05, <0.001, <0.001, <0.01 respectively when compared to values at admission. No significant side effects were seen with remdesivir infusion. CONCLUSION: This real-world experience suggests that in the subset of hospitalized patients with moderate to severe pneumonia, early use of Remdesivir can lead to better clinical outcomes and help in reduction of associated mortality and morbidity of COVID-19.

Kikuchi-Fujimoto's Disease: Clinicopathological Correlation.

Kikuchi-Fujimoto's disease is a benign, self-limiting disorder characterized by regional tender lymphadenopathy fever and night sweats. It most commonly affects Asian adult females younger than 40 years of age. We report a case of 26 year female who presented with cervical lymphadenopathy, which on FNAC revealed Necrotizing Granulomatous inflammation which was unresponsive for three months of antitubercular therapy. A diagnosis of Kikuchi Fujimoto's disease was suggested on review of the slides at our institute and a biopsy confirmed the diagnosis.

Effects of oral fixed-dose combinations of telmisartan plus ramipril and losartan plus ramipril in hypertension: A multicenter, prospective, randomized, double-blind, phase iii trial in adult indian patients.

BACKGROUND: A new oral fixed-dose combination (FDC) of telmisartan plus ramipril is being introduced in India for the treatment of patients with stage 2 hypertension. OBJECTIVE: The aim of this study was to compare the effectiveness and tolerability of an oral FDC of telmisartan plus ramipril with those of an oral FDC of losartan plus ramipril in adult Indian patients with stage 2 hypertension. METHODS: This multicenter, prospective, randomized, double-blind, Phase III study was conducted at 5 centers in India. Indian patients aged 18 to 65 years with uncomplicated stage 2 essential hypertension (systolic/diastolic blood pressure [SBP/DBP], >160/>100 mm Hg) were enrolled. After a 2-week placebo run-in period, patients were randomly assigned to receive telmisartan 40 mg plus ramipril 5 mg (T + R) or losartan 50 mg plus ramipril 5 mg (L + R), PO (tablet) QD (before the morning meal) for 8 weeks. Supine blood pressure (BP) was measured at 0 (baseline) and 8 weeks of treatment. The primary end point was the mean reduction from baseline in BP. Responders were classified as patients who had a DBP <90 mm Hg at the end of 8 weeks of therapy. Tolerability was assessed using spontaneous reports of adverse events (AEs) during the follow-up visits and laboratory analyses performed at week 8. RESULTS: A total of 289 patients were enrolled (155 men, 134 women; mean age, 50.74 years). Of these, 8 patients in the T + R group and 7 in the L + R group were lost to follow-up and considered withdrawals. At the end of week 8, the mean percentage reduction in SBP was significantly greater in the T + R group compared with that in the L + R group (24.1% vs 19.4%; P < 0.05). The mean percentage reduction in DBP was also significantly greater in the T + R group compared with that in the L + R group (17.3% vs 12.5%; P < 0.05). The response rates in the T + R and L + R groups were statistically similar (79.1% vs 68.7%). The most common AEs in the T + R and L + R groups were cough (9 [6.1%] and 11 [7.8%] patients, respectively) and headache (7 [4.7%] and 8 [5.7%] patients, respectively). CONCLUSIONS: The results in this study in Indian patients with stage 2 essential hypertension suggest that the FDC of T + R controlled BP more effectively compared with the FDC of L + R over 8 weeks. The response rates were similar between the 2 groups. Both treatments were well tolerated.